Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 34698 | CA |
NPI | 1003392648 |
---|---|
Provider Name | Dr. Skyler Alvord |
First Address | San Clemente, CA 92673-7036 |
Second Address | Mission Viejo, CA 92692-1600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2018 |
Last Update Date | 20/07/2020 |